Citation Nr: 9837370
Decision Date: 12/22/98 Archive Date: 12/30/98
DOCKET NO. 95-23 195 ) DATE
)
)
On appeal from the
Department of Veterans Affairs Regional Office in Togus,
Maine
THE ISSUE
Entitlement to service connection for post traumatic stress
disorder (PTSD).
REPRESENTATION
Appellant represented by: Maine Division of Veterans
Services
WITNESS AT HEARING ON APPEAL
The veteran
ATTORNEY FOR THE BOARD
S. J. Janec, Associate Counsel
INTRODUCTION
The veteran served on active duty with the U.S. Air Force
from March 1957 to May 1959.
This matter comes before the Board of Veterans’ Appeals
(Board) from an April 1995 rating decision of the Togus,
Maine Regional Office (RO) of the Department of Veterans
Affairs (VA) which denied service connection for PTSD.
In December 1996, the Board remanded the matter to the RO for
additional development. The Board is satisfied that the
requested development has been accomplished and will address
the issue below.
CONTENTIONS OF APPELLANT ON APPEAL
The veteran asserts that he has PTSD as a result of his
active service.
DECISION OF THE BOARD
The Board, in accordance with the provisions of 38 U.S.C.A.
§ 7104 (West 1991 & Supp. 1998), has reviewed and considered
all of the evidence and material of record in the veteran's
claims file. Based on a review of the relevant evidence, and
for the following reasons and bases, it is the decision of
the Board that the preponderance of the evidence is against
the claim of service connection for PTSD.
FINDINGS OF FACT
1. All relevant evidence necessary for an equitable
disposition of the veteran's appeal has been obtained.
2. The veteran was exposed to stressor events in service
(plane crashes) that have been verified through official
channels.
3. The medical evidence does not show that the veteran has a
clear diagnosis of PTSD as a result of the verified stressors
to which he was exposed in service.
CONCLUSION OF LAW
PTSD was not incurred or aggravated in service. 38 U.S.C.A.
§ 1131, 5107(b) (West 1991 & Supp. 1998); 38 C.F.R. § 3.102,
3.303, 3.304(f) (1998).
REASONS AND BASES FOR FINDINGS AND CONCLUSION
Initially, we note that we have found that the veteran’s
claim is well grounded within the meaning of 38 U.S.C.A.
§ 5107(a). That is, we find that he has presented a claim
which is plausible. See Murphy v. Derwinski, 1 Vet.App. 78,
81 (1990). The Board is also satisfied that all relevant
facts for the veteran’s claim have been properly developed
and that no further assistance is required in order to comply
with the duty to assist mandated in 38 U.S.C.A. § 5107.
Littke v. Derwinski, 1 Vet.App. 90 (1990).
I. Factual Background
The veteran’s service medical records were destroyed in a
fire at the National Records Processing Center. He has not
claimed that these records contain any evidence of treatment
for PTSD.
Private medical records from Karl V. Larson, M.D., indicate
treatment from the 1950’s to 1988. In an undated statement
it was noted that approximately 20 years ago the veteran fell
and hit his back. In 1980 he had lower back pain. In 1983,
because of family stress and continued back discomfort, he
was taking 450mg of Librium daily. He admitted to problems
with alcohol and Librium addiction. It was noted he was
having chronic anxiety over the past few years. A long
history of nervous episodes and a diagnosis of chronic
anxiety was noted. Records from D.M. Robertson, M.D., show
an entry from January 1983 in which the veteran complained
that his nerves had been bothering him since he quit drinking
seven years earlier, and a January 1984 entry reported that
his nerves were bad as a result of both his family stress and
his back problems. Records from John W. Peterson, M.D.,
dated from January 1992 to December 1993, diagnosed mild
depression in October 1993 and noted that he was being
evaluated for PTSD in November 1993.
VA records dated in October 1993 indicate that the veteran
was diagnosed with anxiety, possibly PTSD, and alcoholism (in
remission) by a social worker.
In a state disability determination examination performed in
February 1994, the veteran described witnessing a plane crash
in service and seeing people die. He also reported
flashbacks and nightmares of combat experiences as well as
the plane crashes. He slept only three to four hours a night
since 1983. He indicated that he began to self-medicate with
alcohol in service and drank to a level to feel calm. He
believed that he was an alcoholic but quit drinking and took
Librium and Valium on and off for years for nervousness. He
was easily irritated and blew up frequently. He also had
numerous physical disabilities which interfered with his
ability to work, most notably back pain which resulted from
five damaged discs. He avoided crowds, had very few friends
and was easily upset. He was unable to work with his hands
because they shook. He was oriented in all three spheres.
The diagnoses were: PTSD; bipolar disorder; dysthymia; and
personality disorder. Physical conditions included high
blood pressure, chronic low back pain, artery spasms,
diabetes, and emphysema.
On VA psychiatric examination in June 1994, the veteran
reported that in 1958 he was present when bombers crashed
near Lockbourne Air Force Base. He witnessed the destruction
and severe disintegration of the aircraft and crew. He was
sent to help retrieve “bits of flesh” after the crash. He
did not have a history of combat. The examiner noted that
there was no evidence of psychosis, delusions or
hallucinations. Additionally, intrusive recollections,
distressing dreams, and flashbacks were not frequent in
recent years. He was oriented to time place and person.
Conversation was logical, coherent and goal-oriented.
Judgment on common issues was good, affected only by
irritability and lack of tolerance. He experienced avoidance
and diminished interest. While there was and had been
symptomatology related to the experience with the crashed
bombers, including changes in mood and outlook, it was
concluded that the criteria for a full diagnosis of PTSD had
not been met. Dysthymia with a history of alcoholism was
diagnosed. The examiner concluded that the veteran’s
prominent symptoms were physical and the loss of self-esteem
was related to his inability to work.
At a personal hearing in November 1995, the veteran testified
that he was part of a crew sent to pick up remains after a B-
47 crashed approximately 30 miles from his base. On another
occasion, he witnessed a test flight crash shortly after
take-off, killing all three passengers aboard. He also
witnessed his line chief being electrocuted during a training
exercise. As a result of these incidents, he left the Air
Force two years early. He did not seek treatment or see a
psychiatrist for his condition while he was in the service.
In a January 1997 statement, the veteran reported that he
witnessed two plane crashes in 1958. He also witnessed the
accidental electrocution of a “Sergeant Taggert” who was a
line chief.
Correspondence from the United States Armed Services Center
for Research of Unit Records (USASCRUR), dated in January
1998, reported that there were three aircraft incident
reports around Lockbourne Air Force Base in 1958, including
the crash of a B-47 bomber. Three officers died in the crash
that occurred on October 23, 1958. USASCRUR was unable to
verify the incident with “Sergeant Taggert.”
On VA psychiatric examination in April 1998, the veteran
recalled that he witnessed two plane crashes while he was
stationed at Lockboure Air Force Base. During these events,
he was not in harm’s way, he was not injured and his life was
not in jeopardy. However, he experienced anxiety after the
events and requested an early release from the Air Force.
Presently, he had numerous medical difficulties including
diabetes, high blood pressure, kidney trouble, emphysema,
knee problems and a chronic back ailment. He was first seen
for mental problems in 1993 and was diagnosed with depression
and bipolar disorder. In reviewing the veteran's records,
the examiner noted that the veteran was examined by a
licensed psychologist in February 1994 and was diagnosed with
PTSD, bipolar disorder and dysthymia. He was also previously
seen for a VA examination in June 1994 and was diagnosed with
dysthymia with a history of alcoholism. Psychological tests
were administered, including the MMPI-II, the MCMI-II and a
follow-up PTSD Diagnostic Scale. Results of the MMPI-II
suggested somatic discomfort and pain. The veteran presented
as anxious, tense and nervous. The profile suggested that
the veteran was high-strung, prone to worry, was restless and
irritable, and unhappy. He had little energy and drive. The
MCMI-II was consistent with that picture and also suggested
that the veteran was avoidant and isolative. The follow-up
PTSD scale indicated PTSD type symptoms such as arousal and
difficulty getting to sleep and staying asleep. However, the
examiner concluded that these symptoms were not due to the
identified stressors in service, but were due to the
veteran's multiple physical and medical problems which were
quite serious. Dysthymic disorder, late onset, was
diagnosed.
II. Analysis
Service connection for PTSD requires medical evidence
establishing a clear diagnosis of the condition, and credible
supporting evidence that the claimed in-service stressor
actually occurred, as well as a link, established by the
medical evidence, between current symptomatology and the
claimed in-service stressor. 38 C.F.R. § 3.304(f) (1998);
Zarycki v. Brown, 6 Vet.App. 91 (1993); ); Cohen v. Brown, 10
Vet. App. 128, 138 (1997). If the claimed in-service
stressor is related to combat, service department evidence
that the veteran engaged in combat or that the veteran was
awarded a combat citation will be accepted, in the absence of
evidence to the contrary, as conclusive evidence of the
claimed in-service stressor. Id.
In Zarycki, the United States Court of Veteran's Appeals
(Court) set forth the analytical framework for establishing a
veteran's exposure to a stressor during service, a critical
element in the determination of whether a veteran has PTSD.
Accordingly, service connection may not be granted for PTSD
based on a diagnosis unsupported by credible evidence of an
in-service stressor. Similarly, a clear diagnosis of PTSD
must be based on exposure to the verified stressor event in
service.
In this case, the Board observes that the veteran’s service
medical records have been reported to be destroyed by fire.
However, the veteran does not assert that the records would
document any treatment for PTSD in service. Additionally,
the record does not show that he participated in combat, as
at times alleged by the veteran. In fact, his period of
service did not fall within a period of war. See 38 C.F.R.
§ 3.2. However, two of the stressor events to which the
veteran alleged he was exposed during his active duty have
been verified by the USASCRUR, the plane crashes. Therefore,
exposure to two in-service stressors has been established.
Nonetheless, the medical evidence does not show a clear
diagnosis of PTSD based on these verified stressors. On both
VA examinations in June 1994 and April 1998, it was found
that the veteran did not meet the criteria for a full
diagnosis of PTSD. In fact, on VA examination in April 1998,
the examiner administered several psychological evaluations,
including a PTSD scale, and concluded that the veteran did
experience some PTSD symptomatology; however, those symptoms
were not due to the stressor events in service but were due
to his numerous physical and medical problems. Dysthymia was
diagnosed in both June 1994 and April 1998. While the record
does show that the veteran was diagnosed with PTSD on an
examination in February 1994 which was undertaken in
conjunction with his claim for state disability benefits, the
Board finds that the conclusions of the VA examiners are more
persuasive. They included detailed evaluations with
individual psychiatric testing and were undertaken
specifically to determine whether the veteran had PTSD.
Additionally, the April 1998 examiner reviewed all of the
veteran's medical records including the February 1994 state
disability determination and found that the PTSD symptoms
were not due to his identified stressors in service, but were
due to his multiple physical and medical problems. As such,
the Board concludes that the preponderance of the evidence is
against the veteran’s claim and service connection for PTSD
as the result of service must be denied.
ORDER
Service connection for PTSD is denied.
STEVEN L. COHN
Member, Board of Veterans' Appeals
NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West
1991 & Supp. 1998), a decision of the Board of Veterans'
Appeals granting less than the complete benefit, or benefits,
sought on appeal is appealable to the United States Court of
Veterans Appeals within 120 days from the date of mailing of
notice of the decision, provided that a Notice of
Disagreement concerning an issue which was before the Board
was filed with the agency of original jurisdiction on or
after November 18, 1988. Veterans' Judicial Review Act,
Pub. L. No. 100-687, § 402, 102 Stat. 4105, 4122 (1988). The
date which appears on the face of this decision constitutes
the date of mailing and the copy of this decision which you
have received is your notice of the action taken on your
appeal by the Board of Veterans' Appeals.
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